摘要
目的:评估噻托溴铵联合布地奈德吸入治疗对哮喘-慢阻肺重叠综合征(ACOS)患者肺功能和睡眠质量的影响。方法:以2019年1月至2024年1月在本院接受治疗的98例ACOS患者为样本。采用随机数字表法简单随机等分分为两组,每组49例。对照组采用布地奈德吸入治疗,观察组在对照组的基础上联合应用噻托溴铵,两组均连续治疗3个月。比较两组患者治疗前后的炎症水平[白介素6(IL-6)、肿瘤坏死因子α(TNF-α)、超敏C反应蛋白(hs-CRP)]、免疫功能[辅助性T细胞17(Th17)、调节性T细胞(Treg)、Th17/Treg]、气道重塑因子[转化生长因子-β1(TGF-β1)、骨桥蛋白(OPN)、基质金属蛋白酶-9(MMP-9)]、肺功能[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、每分钟最大自主通气量(MVV)]。并通过慢性阻塞性肺疾病评分(CAT)、哮喘患者症状评分(ACT)评估患者治疗前后的疾病症状,并在治疗3个月后通过匹兹堡睡眠质量指数(PSQI)量表比较两组睡眠质量。结果:治疗前,两组患者血清炎性因子、Th17、Th17/Treg、气道重塑因子水平、肺功能、CAT和PSQI评分差异无统计学意义(P>0.05);较治疗前,两组治疗后血清IL-6、TNF-α、hs-CRP、Th17、Th17/Treg、TGF-β1、OPN、MMP-9水平、ACT、CAT评分均下降,Treg水平、肺功能FEV1、FVC、MVV水平均升高,差异有统计学意义(P<0.05);两组血清炎性因子、Th17、Th17/Treg、气道重塑因子水平、肺功能、CAT和PSQI评分治疗前后差值比较,差异有统计学意义(P<0.05);观察组治疗后的睡眠状况优于对照组,差异有统计学意义(P<0.05)。结论:在ACOS的治疗中联合应用噻托溴铵和布地奈德有助于改善的肺功能和睡眠质量。
Objective:To evaluate the effect of tiotropium bromide combined with budesonide inhalation therapy on lung function and sleep quality in patients with asthma-chronic obstructive pulmonary disease overlap syndrome(ACOS).Methods:A total of 98 ACOS patients treated in our hospital from January 2019 to January 2024 were sampled.They were divided into two groups using the random number table method,with 49 cases in each group.The control group was treated with budesonide inhalation,and the observation group was treated with tiotropium bromide based on the control group.Both groups were treated for 3 months.The two groups of patients were compared before and after treatment in terms of inflammation levels[interleukin 6(IL-6),tumor necrosis factor alpha(TNF alpha),hypersensitive c-reactive protein(hs-CRP)],im-mune function[17(Th17 and regulatory T helper T cells,of Th17/Treg cells(Treg)],airway remodeling factor[transforming growth factor beta 1-(TGFβ1)and osteopontin(OPN)and matrix metalloproteinases 9(MMP 9)],lung function(forced expiratory volume in 1 second(FEV1)and forced vital capacity(FVC),and the largest independent ventilation per minute(MVV).Chronic obstructive pulmonary disease(CAT)score and asthma symptom score(ACT)were used to evaluate the disease symptoms before and after treat-ment,and Pittsburgh Sleep Quality Index(PSQI)scale was used to compare the sleep quality of the two groups after 3 months of treatment.Results:Before treatment,there were no significant differences in serum inflammatory factors,Th17,Th17/Treg,airway remodeling factors,lung function,CAT,and PSQI scores be-tween the two groups(P>0.05).Compared with before treatment,the serum IL-6,TNF-α,hs-CRP,Th17,Th17/Treg,TGF-β1,OPN,MMP-9 levels,ACT and CAT scores in both groups were decreased after treatment,while Treg level,lung function FEV1,FVC,and MVV levels were increased.The difference was statistically significant(P<0.05).There were statistically significant differences in serum inflammatory fac-tors,Th17,Th17/Treg,airway remodeling factors,lung function,CAT,and PSQI scores before and after treatment between the two groups(P<0.05).The sleep status of the observation group after treatment was better than that of the control group,and the difference was statistically significant(P<0.05).Conclusion:The combination of tiotropium and budesonide in the treatment of ACOS helps improve lung function and sleep quality.
作者
王保兰
王亮
马婷
WANG Baolan;WANG Liang;MA Ting(Huai'an No.1 Hospital Affiliated to Nanjing Medical University,Jiangsu Huai'an 223000,China)
出处
《河北医学》
CAS
2024年第8期1309-1315,共7页
Hebei Medicine
基金
江苏省重点研发计划项目,编号(SBE2020651)。
关键词
噻托溴铵
布地奈德
哮喘-慢阻肺重叠综合征
肺功能
睡眠质量
Tiotropium
Budesonide
Asthma obstructive pulmonary disease overlap syn-drome
Pulmonary function
Quality of sleep
